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Study shows link between cross-linking and persistent corneal edema
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Collagen cross-linking in the treatment of keratoconus posed a risk of persistent corneal edema and corneal endothelial damage, according to a study.
The retrospective study included 350 patients with progressive keratoconus who underwent collagen cross-linking with riboflavin and ultraviolet A irradiation. Average patient age was 22 years.
The analysis included patients with corneal edema that persisted longer than 3 weeks.
The investigators analyzed preoperative and postoperative best corrected visual acuity, refraction, keratometry, pachymetry and corneal topography. Mean follow-up was 14 months.
Preoperatively, median logMAR BCVA was 0.00, median maximum keratometry was 57.4 D, and mean pachymetry was 472.6 µm.
Study results showed that postoperative corneal edema was identified in 10 patients (2.9%). Edema developed on postoperative day 1 and persisted for 3 weeks in all 10 patients.
Postoperative median BCVA was 0.60. The change was statistically significant (P < .0001). Median maximum keratometry was 54.7 D (P = .0043). Mean pachymetry was 654.5 µm at 3 weeks, 637.9 µm at 3 months, 614.8 µm at 6 months and 595.7 µm at 12 months (P < .0001 at all follow-up points).
Penetrating keratoplasty was recommended for five patients, but only two agreed to undergo the surgery. Five patients regained endothelial function without surgical intervention. Four patients had improved corneal edema, and one had resolved edema.
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